Vascular cognitive impairment

Introduction
Article section 1 of 14.  Next

By John V Bowler MD and Vladimir C Hachinski MD

Vascular cognitive impairment is also known as or subsumes Vascular dementia. -ed.

Vascular cognitive impairment (VCI) has superseded vascular dementia because of the limitations of the concept of vascular dementia. In this article, the conceptual basis of vascular cognitive impairment is reviewed along with a critique of the old criteria for vascular dementia. Also reviewed are developments in the management of vascular cognitive impairment, in which there have been advances in both slowing disease progression and in symptomatic relief.

Key Points

  • Subcortical vascular cognitive impairment due to small vessel cerebrovascular disease is the commonest form of vascular cognitive impairment.
  • Affected domains typically include frontal and executive functions.
  • Vascular cognitive impairment commonly coexists with Alzheimer disease and produces mixed dementia, which is the commonest form of dementia.
  • Multi-infarct dementia is rare.
  • Modern practice concentrates on early detection with a view to the prevention of progression wherever possible.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Anesthesia
References cited
Contributors